Typical Woman – she just can’t make up her mind. Posted April 18th 2021
More to come on this interesting case.
Cogito ergo sum – Posted with comment by R.J Cook
It may seem odd to post an article on Descartean dualism on one of the two toxic transgender clinic pages. The ignorant usually think only of sex and kinky cross dressers when it comes to those who ‘think’ they are the opposite sex. Some feminists become incredibly hostile , seeing MTF as a threat to their self righteous hectoring hegemony.
Many men are attracted to male to certain female transsexuals because those ‘women’ aspire to an old fashioned caring and elegant image which is no longer commonplace as average women become ever more assertive , competitive, aggrieved and disgruntled.
However, the body clearly plays an important part in their ‘gender identity.’ The methods used to diagnose gender identity issues , as per the the likes of Britain’s Tavistock Gender Identity Clinic are vague , in my view , ideological and based on the general premise that those who choose it are not mentally ill.
However, they cover themselves against misconduct claims, with the interesting statement that , many of their patients have other mental health problems so bad that they might commit suicide – begging the question how can seriously mentally ill people be trusted when they pesent themselves as transgendered in the first place ? . On the basis of ‘inductive logic’ ( contrdictions in terms ) they argue that every case is successful dignosis because far more of their ‘successes’ would have killed themselves without the surgery.
Philosophy was one of my six compulsory foundation year subjects from an intensive economics and economic history degree course at the University of East Anglia in the early 1970s. I found the subject perplexing and seemingly hard to follow. Descartes was early on the agenda and seemed like nonsense.. I was even more perplexed when my philosophy tutor told me that my work and seminar contributions were outstanding and that I should choose it as my major subject.
I chose not to because it didn’t seem like a real subject. However , when I attended an old faculty meeting in 2005, I ended up giving it a forceful defence from attack by a thundering woman mourning the demise of sociology at the University.
By this time , life had taught me the great value of ‘truth’ seeking philosophy. As a former college lecturer and Oxford University A level examiner, I had formed the conclusion that so called Critical Sociology , along with Critical Race Theory , had no claim to truth seeking. It was pure ideology with a subtle social engineering agenda. The police love it. So, after my talk, Tim O’Hagan Professor Emeritus in philosophy, thanked me heartily while vigorously shaking my hand.
I must however, conclude that Descartes had good ideas but the mind would be rather lonely and poorly defined – like Krang from The Turtles’ – without a body. Having said that, I knew a man a few years ago who was run over aged 7 , most of his body paralysed for the next 70 years. That body could not function properly without his brain , and vice versa. There is evidence that memories and other data are stored in other organs and have been transferred to other people via transplants.
The beauty of honest philosophy is that its proponents keep on asking questions. The ugliness of modern sociology is in the way it is warped and fixed for oppresive control purposes in the modern Police State. It is all very well to offer the alleged freedoms of gender choice , but the thinking behind it is suspect. If the mind is separate then it shouldn’t matter what the body is. If the body and mind talk to each other , it poses the question which department makes the gender switch choice and why ? Or is the issue being resolved by the State’s social engineers to resolve some very serious problems and tensions that the ruling elite have deliberately caused ?
The Mind-Body Distinction
One of the deepest and most lasting legacies of Descartes’ philosophy is his thesis that mind and body are really distinct—a thesis now called “mind-body dualism.” He reaches this conclusion by arguing that the nature of the mind (that is, a thinking, non-extended thing) is completely different from that of the body (that is, an extended, non-thinking thing), and therefore it is possible for one to exist without the other. This argument gives rise to the famous problem of mind-body causal interaction still debated today: how can the mind cause some of our bodily limbs to move (for example, raising one’s hand to ask a question), and how can the body’s sense organs cause sensations in the mind when their natures are completely different? This article examines these issues as well as Descartes’ own response to this problem through his brief remarks on how the mind is united with the body to form a human being. This will show how these issues arise because of a misconception about Descartes’ theory of mind-body union, and how the correct conception of their union avoids this version of the problem. The article begins with an examination of the term “real distinction” and of Descartes’ probable motivations for maintaining his dualist thesis.
Table of Contents
- What is a Real Distinction?
- Why a Real Distinction?
- The Real Distinction Argument
- The Mind-Body Problem
- Descartes’ Response to the Mind-Body Problem
- References and Further Reading
1. What is a Real Distinction?
It is important to note that for Descartes “real distinction” is a technical term denoting the distinction between two or more substances (see Principles, part I, section 60). A substance is something that does not require any other creature to exist—it can exist with only the help of God’s concurrence—whereas, a mode is a quality or affection of that substance (see Principles part I, section 5). Accordingly, a mode requires a substance to exist and not just the concurrence of God. Being sphere shaped is a mode of an extended substance. For example, a sphere requires an object extended in three dimensions in order to exist: an unextended sphere cannot be conceived without contradiction. But a substance can be understood to exist alone without requiring any other creature to exist. For example, a stone can exist all by itself. That is, its existence is not dependent upon the existence of minds or other bodies; and, a stone can exist without being any particular size or shape. This indicates for Descartes that God, if he chose, could create a world constituted by this stone all by itself, showing further that it is a substance “really distinct” from everything else except God. Hence, the thesis that mind and body are really distinct just means that each could exist all by itself without any other creature, including each other, if God chose to do it. However, this does not mean that these substances do exist separately. Whether or not they actually exist apart is another issue entirely.
2. Why a Real Distinction?
A question one might ask is: what’s the point of arguing that mind and body could each exist without the other? What’s the payoff for going through all the trouble and enduring all the problems to which it gives rise? For Descartes the payoff is twofold. The first is religious in nature in that it provides a rational basis for a hope in the soul’s immortality [because Descartes presumes that the mind and soul are more or less the same thing]. The second is more scientifically oriented, for the complete absence of mentality from the nature of physical things is central to making way for Descartes’ version of the new, mechanistic physics. This section investigates both of these motivating factors.
a. The Religious Motivation
In his Letter to the Sorbonne published at the beginning of his seminal work, Meditations on First Philosophy, Descartes states that his purpose in showing that the human mind or soul is really distinct from the body is to refute those “irreligious people” who only have faith in mathematics and will not believe in the soul’s immortality without a mathematical demonstration of it. Descartes goes on to explain how, because of this, these people will not pursue moral virtue without the prospect of an afterlife with rewards for virtue and punishments for vice. But, since all the arguments in the Meditations—including the real distinction arguments— are for Descartes absolutely certain on a par with geometrical demonstrations, he believes that these people will be obliged to accept them. Hence, irreligious people will be forced to believe in the prospect of an afterlife. However, recall that Descartes’ conclusion is only that the mind or soul can exist without the body. He stops short of demonstrating that the soul is actually immortal. Indeed, in the Synopsis to the Mediations, Descartes claims only to have shown that the decay of the body does not logically or metaphysically imply the destruction of the mind: further argumentation is required for the conclusion that the mind actually survives the body’s destruction. This would involve both “an account of the whole of physics” and an argument showing that God cannot annihilate the mind. Yet, even though the real distinction argument does not go this far, it does, according to Descartes, provide a sufficient foundation for religion, since the hope for an afterlife now has a rational basis and is no longer a mere article of faith.
b. The Scientific Motivation
The other motive for arguing that mind and body could each exist without the other is more scientifically oriented, stemming from Descartes’ intended replacement of final causal explanations in physics thought to be favored by late scholastic-Aristotelian philosophers with mechanistic explanations based on the model of geometry. Although the credit for setting the stage for this scholastic-Aristotelian philosophy dominant at Descartes’ time should go to Thomas Aquinas (because of his initial, thorough interpretation and appropriation of Aristotle’s philosophy), it is also important to bear in mind that other thinkers working within this Aristotelian framework such as Duns Scotus, William of Ockham, and Francisco Suarez, diverged from the Thomistic position on a variety of important issues. Indeed, by Descartes’ time, scholastic positions divergent from Thomism became so widespread and subtle in their differences that sorting them out was quite difficult. Notwithstanding this convoluted array of positions, Descartes understood one thesis to stand at the heart of the entire tradition: the doctrine that everything ultimately behaved for the sake of some end or goal. Though these “final causes,” as they were called, were not the only sorts of causes recognized by scholastic thinkers, it is sufficient for present purposes to recognize that Descartes believed scholastic natural philosophers used them as principles for physical explanations. For this reason, a brief look at how final causes were supposed to work is in order.
Descartes understood all scholastics to maintain that everything was thought to have a final cause that is the ultimate end or goal for the sake of which the rest of the organism was organized. This principle of organization became known as a thing’s “substantial form,” because it was this principle that explained why some hunk of matter was arranged in such and such a way so as to be some species of substance. For example, in the case of a bird, say, the swallow, the substantial form of swallowness was thought to organize matter for the sake of being a swallow species of substance. Accordingly, any dispositions a swallow might have, such as the disposition for making nests, would then also be explained by means of this ultimate goal of being a swallow; that is, swallows are disposed for making nests for the sake of being a swallow species of substance. This explanatory scheme was also thought to work for plants and inanimate natural objects.
A criticism of the traditional employment of substantial forms and their concomitant final causes in physics is found in the Sixth Replies where Descartes examines how the quality of gravity was used to explain a body’s downward motion:
But what makes it especially clear that my idea of gravity was taken largely from the idea I had of the mind is the fact that I thought that gravity carried bodies toward the centre of the earth as if it had some knowledge of the centre within itself (AT VII 442: CSM II 298).
On this pre-Newtonian account, a characteristic goal of all bodies was to reach its proper place, namely, the center of the earth. So, the answer to the question, “Why do stones fall downward?” would be, “Because they are striving to achieve their goal of reaching the center of the earth.” According to Descartes, this implies that the stone must have knowledge of this goal, know the means to attain it, and know where the center of the earth is located. But, how can a stone know anything? Surely only minds can have knowledge. Yet, since stones are inanimate bodies without minds, it follows that they cannot know anything at all—let alone anything about the center of the earth.
Descartes continues on to make the following point:
But later on I made the observations which led me to make a careful distinction between the idea of the mind and the ideas of body and corporeal motion; and I found that all those other ideas of . . . ‘substantial forms’ which I had previously held were ones which I had put together or constructed from those basic ideas (AT VII 442-3: CSM II 298).
Here, Descartes is claiming that the concept of a substantial form as part of the entirely physical world stems from a confusion of the ideas of mind and body. This confusion led people to mistakenly ascribe mental properties like knowledge to entirely non-mental things like stones, plants, and, yes, even non-human animals. The real distinction of mind and body can then also be used to alleviate this confusion and its resultant mistakes by showing that bodies exist and move as they do without mentality, and as such principles of mental causation such as goals, purposes (that is, final causes), and knowledge have no role to play in the explanation of physical phenomena. So the real distinction of mind and body also serves the more scientifically oriented end of eliminating any element of mentality from the idea of body. In this way, a clear understanding of the geometrical nature of bodies can be achieved and better explanations obtained.
3. The Real Distinction Argument
Descartes formulates this argument in many different ways, which has led many scholars to believe there are several different real distinction arguments. However, it is more accurate to consider these formulations as different versions of one and the same argument. The fundamental premise of each is identical: each has the fundamental premise that the natures of mind and body are completely different from one another.
The First Version
The first version is found in this excerpt from the Sixth Meditation:
[O]n the one hand I have a clear and distinct idea of myself, in so far as I am simply a thinking, non-extended thing [that is, a mind], and on the other hand I have a distinct idea of body, in so far as this is simply an extended, non-thinking thing. And accordingly, it is certain that I am really distinct from my body, and can exist without it (AT VII 78: CSM II 54).
Notice that the argument is given from the first person perspective (as are the entire Meditations). This “I” is, of course, Descartes insofar as he is a thinking thing or mind, and the argument is intended to work for any “I” or mind. So, for present purposes, it is safe to generalize the argument by replacing “I” with “mind” in the relevant places:
- I have a clear and distinct idea of the mind as a thinking, non-extended thing.
- I have a clear and distinct idea of body as an extended, non-thinking thing.
- Therefore, the mind is really distinct from the body and can exist without it.
At first glance it may seem that, without justification, Descartes is bluntly asserting that he conceives of mind and body as two completely different things, and that from his conception, he is inferring that he (or any mind) can exist without the body. But this is no blunt, unjustified assertion. Much more is at work here: most notably what is at work is his doctrine of clear and distinct ideas and their veridical guarantee. Indeed the truth of his intellectual perception of the natures of mind and body is supposed to be guaranteed by the fact that this perception is “clear and distinct.” Since the justification for these two premises rests squarely on the veridical guarantee of whatever is “clearly and distinctly” perceived, a brief side trip explaining this doctrine is in order.
Descartes explains what he means by a “clear and distinct idea” in his work Principles of Philosophy at part I, section 45. Here he likens a clear intellectual perception to a clear visual perception. So, just as someone might have a sharply focused visual perception of something, an idea is clear when it is in sharp intellectual focus. Moreover, an idea is distinct when, in addition to being clear, all other ideas not belonging to it are completely excluded from it. Hence, Descartes is claiming in both premises that his idea of the mind and his idea of the body exclude all other ideas that do not belong to them, including each other, and all that remains is what can be clearly understood of each. As a result, he clearly and distinctly understands the mind all by itself, separately from the body, and the body all by itself, separately from the mind.
According to Descartes, his ability to clearly and distinctly understand them separately from one another implies that each can exist alone without the other. This is because “[e]xistence is contained in the idea or concept of every single thing, since we cannot conceive of anything except as existing. Possible or contingent existence is contained in the concept of a limited thing…” (AT VII 166: CSM II 117). Descartes, then, clearly and distinctly perceives the mind as possibly existing all by itself, and the body as possibly existing all by itself. But couldn’t Descartes somehow be mistaken about his clear and distinct ideas? Given the existence of so many non-thinking bodies like stones, there is no question that bodies can exist without minds. So, even if he could be mistaken about what he clearly and distinctly understands, there is other evidence in support of premise 2. But can minds exist without bodies? Can thinking occur without a brain? If the answer to this question is “no,” the first premise would be false and, therefore, Descartes would be mistaken about one of his clear and distinct perceptions. Indeed, since we have no experience of minds actually existing without bodies as we do of bodies actually existing without minds, the argument will stand only if Descartes’ clear and distinct understanding of the mind’s nature somehow guarantees the truth of premise 1; but, at this point, it is not evident whether Descartes’ “clear and distinct” perception guarantees the truth of anything.
However, in the Fourth Meditation, Descartes goes to great lengthsto guarantee the truth of whatever is clearly and distinctly understood. This veridical guarantee is based on the theses that God exists and that he cannot be a deceiver. These arguments, though very interesting, are numerous and complex, and so they will not be discussed here. Suffice it to say that since Descartes believes he has established God’s inability to deceive with absolute, geometrical certainty, he would have to consider anything contradicting this conclusion to be false. Moreover, Descartes claims that he cannot help but believe clear and distinct ideas to be true. However, if God put a clear and distinct idea in him that was false, then he could not help but believe a falsehood to be true and, to make matters worse, he would never be able to discover the mistake. Since God would be the author of this false clear and distinct idea, he would be the source of the error and would, therefore, be a deceiver, which must be false. Hence, all clear and distinct ideas must be true, because it is impossible for them to be false given God’s non-deceiving nature.
That said, the clarity and distinctness of Descartes’ understanding of mind and body guarantees the truth of premise 1. Hence, both “clear and distinct” premises are not blunt, unjustified assertions of what he believes but have very strong rational support from within Descartes’ system. However, if it turns out that God does not exist or that he can be a deceiver, then all bets are off. There would then no longer be any veridical guarantee of what is clearly and distinctly understood and, as a result, the first premise could be false. Consequently, premise 1 would not bar the possibility of minds requiring brains to exist and, therefore, this premise would not be absolutely certain as Descartes supposed. In the end, the conclusion is established with absolute certainty only when considered from within Descartes’ own epistemological framework but loses its force if that framework turns out to be false or when evaluated from outside of it.
These guaranteed truths express some very important points about Descartes’ conception of mind and body. Notice that mind and body are defined as complete opposites. This means that the ideas of mind and body represent two natures that have absolutely nothing in common. And, it is this complete diversity that establishes the possibility of their independent existence. But, how can Descartes make a legitimate inference from his independent understanding of mind and body as completely different things to their independent existence? To answer this question, recall that every idea of limited or finite things contains the idea of possible or contingent existence, and so Descartes is conceiving mind and body as possibly existing all by themselves without any other creature. Since there is no doubt about this possibility for Descartes and given the fact that God is all powerful, it follows that God could bring into existence a mind without a body and vice versa just as Descartes clearly and distinctly understands them. Hence, the power of God makes Descartes’ perceived logical possibility of minds existing without bodies into a metaphysical possibility. As a result, minds without bodies and bodies without minds would require nothing besides God’s concurrence to exist and, therefore, they are two really distinct substances.
The Second Version
The argument just examined is formulated in a different way later in the Sixth Meditation:
[T]here is a great difference between the mind and the body, inasmuch as the body is by its very nature always divisible, while the mind is utterly indivisible. For when I consider the mind, or myself in so far as I am merely a thinking thing, I am unable to distinguish any parts within myself; I understand myself to be something quite single and complete….By contrast, there is no corporeal or extended thing that I can think of which in my thought I cannot easily divide into parts; and this very fact makes me understand that it is divisible. This one argument would be enough to show me that the mind is completely different from the body…. (AT VII 86-87: CSM II 59).
This argument can be reformulated as follows, replacing “mind” for “I” as in the first version:
- I understand the mind to be indivisible by its very nature.
- I understand body to be divisible by its very nature.
- Therefore, the mind is completely different from the body.
Notice the conclusion that mind and body are really distinct is not explicitly stated but can be inferred from 3. What is interesting about this formulation is how Descartes reaches his conclusion. He does not assert a clear and distinct understanding of these two natures as completely different but instead makes his point based on a particular property of each. However, this is not just any property but a property each has “by its very nature.” Something’s nature is just what it is to be that kind of thing, and so the term “nature” is here being used as synonymous with “essence.” On this account, extension constitutes the nature or essence of bodily kinds of things; while thinking constitutes the nature or essence of mental kinds of things. So, here Descartes is arguing that a property of what it is to be a body, or extended thing, is to be divisible, while a property of what it is to be a mind or thinking thing is to be indivisible.
Descartes’ line of reasoning in support of these claims about the respective natures of mind and body runs as follows. First, it is easy to see that bodies are divisible. Just take any body, say a pencil or a piece of paper, and break it or cut it in half. Now you have two bodies instead of one. Second, based on this line of reasoning, it is easy to see why Descartes believed his nature or mind to be indivisible: if a mind or an “I” could be divided, then two minds or “I’s” would result; but since this “I” just is my self, this would be the same as claiming that the division of my mind results in two selves, which is absurd. Therefore, the body is essentially divisible and the mind is essentially indivisible: but how does this lead to the conclusion that they are completely different?
Here it should be noted that a difference in just any non-essential property would have only shown that mind and body are not exactly the same. But this is a much weaker claim than Descartes’ conclusion that they are completely different. For two things could have the same nature, for example, extension, but have other, changeable properties or modes distinguishing them. Hence, these two things would be different in some respect, for example, in shape, but not completely different, since both would still be extended kinds of things. Consequently, Descartes needs their complete diversity to claim that he has completely independent conceptions of each and, in turn, that mind and body can exist independently of one another.
Descartes can reach this stronger conclusion because these essential properties are contradictories. On the one hand, Descartes argues that the mind is indivisible because he cannot perceive himself as having any parts. On the other hand, the body is divisible because he cannot think of a body except as having parts. Hence, if mind and body had the same nature, it would be a nature both with and without parts. Yet such a thing is unintelligible: how could something both be separable into parts and yet not separable into parts? The answer is that it can’t, and so mind and body cannot be one and the same but two completely different natures. Notice that, as with the first version, mind and body are here being defined as opposites. This implies that divisible body can be understood without indivisible mind and vice versa. Accordingly each can be understood as existing all by itself: they are two really distinct substances.
However, unlike the first version, Descartes does not invoke the doctrine of clear and distinct ideas to justify his premises. If he had, this version, like the first, would be absolutely certain from within Descartes’ own epistemological system. But if removed from this apparatus, it is possible that Descartes is mistaken about the indivisibility of the mind, because the possibility of the mind requiring a brain to exist would still be viable. This would mean that, since extension is part of the nature of mind, it would, being an extended thing, be composed of parts and, therefore, it would be divisible. As a result, Descartes could not legitimately reach the conclusion that mind and body are completely different. This would also mean that the further, implicit conclusion that mind and body are really distinct could not be reached either. In the end, the main difficulty with Descartes’ real distinction argument is that he has not adequately eliminated the possibility of minds being extended things like brains.
4. The Mind-Body Problem
The real distinction of mind and body based on their completely diverse natures is the root of the famous mind-body problem: how can these two substances with completely different natures causally interact so as to give rise to a human being capable of having voluntary bodily motions and sensations? Although several versions of this problem have arisen over the years, this section will be exclusively devoted to the version of it Descartes confronted as expressed by Pierre Gassendi, the author of the Fifth Objections, and Descartes’ correspondent, Princess Elizabeth of Bohemia. Their concern arises from the claim at the heart of the real distinction argument that mind and body are completely different or opposite things.
The complete diversity of their respective natures has serious consequences for the kinds of modes each can possess. For instance, in the Second Meditation, Descartes argues that he is nothing but a thinking thing or mind, that is, Descartes argues that he is a “thing that doubts, understands, affirms, denies, is willing, is unwilling, and also imagines and has sensory perceptions” (AT VII 28: CSM II 19). It makes no sense to ascribe such modes to entirely extended, non-thinking things like stones, and therefore, only minds can have these kinds of modes. Conversely, it makes no sense to ascribe modes of size, shape, quantity and motion to non-extended, thinking things. For example, the concept of an unextended shape is unintelligible. Therefore, a mind cannot be understood to be shaped or in motion, nor can a body understand or sense anything. Human beings, however, are supposed to be combinations of mind and body such that the mind’s choices can cause modes of motion in the body, and motions in certain bodily organs, such as the eye, cause modes of sensation in the mind.
The mind’s ability to cause motion in the body will be addressed first. Take for example a voluntary choice, or willing, to raise one’s hand in class to ask a question. The arm moving upward is the effect while the choice to raise it is the cause. But willing is a mode of the non-extended mind alone, whereas the arm’s motion is a mode of the extended body alone: how can the non-extended mind bring about this extended effect? It is this problem of voluntary bodily motion or the so-called problem of “mind to body causation” that so troubled Gassendi and Elizabeth. The crux of their concern was that in order for one thing to cause motion in another, they must come into contact with one another as, for example, in the game of pool the cue ball must be in motion and come into contact with the eight-ball in order for the latter to be set in motion. The problem is that, in the case of voluntarily bodily movements, contact between mind and body would be impossible given the mind’s non-extended nature. This is because contact must be between two surfaces, but surface is a mode of body, as stated at Principles of Philosophy part II, section 15. Accordingly, the mind does not have a surface that can come into contact with the body and cause it to move. So, it seems that if mind and body are completely different, there is no intelligible explanation of voluntary bodily movement.
Although Gassendi and Elizabeth limited themselves to the problem of voluntary bodily movement, a similar problem arises for sensations, or the so-called problem of “body to mind causation.” For instance, a visual sensation of a tree is a mode of the mind alone. The cause of this mode would be explained by the motion of various imperceptible bodies causing parts of the eye to move, then movements in the optic nerve, which in turn cause various “animal spirits” to move in the brain and finally result in the sensory idea of the tree in the mind. But how can the movement of the “animal spirits,” which were thought to be very fine bodies, bring about the existence of a sensory idea when the mind is incapable of receiving modes of motion given its non-extended nature? Again, since the mind is incapable of having motion and a surface, no intelligible explanation of sensations seems possible either. Therefore, the completely different natures of mind and body seem to render their causal interaction impossible.
The consequences of this problem are very serious for Descartes, because it undermines his claim to have a clear and distinct understanding of the mind without the body. For humans do have sensations and voluntarily move some of their bodily limbs and, if Gassendi and Elizabeth are correct, this requires a surface and contact. Since the mind must have a surface and a capacity for motion, the mind must also be extended and, therefore, mind and body are not completely different. This means the “clear and distinct” ideas of mind and body, as mutually exclusive natures, must be false in order for mind-body causal interaction to occur. Hence, Descartes has not adequately established that mind and body are two really distinct substances.
5. Descartes’ Response to the Mind-Body Problem
Despite the obviousness of this problem, and the amount of attention given to it, Descartes himself never took this issue very seriously. His response to Gassendi is a telling example:
These questions presuppose amongst other things an explanation of the union between the soul and the body, which I have not yet dealt with at all. But I will say, for your benefit at least, that the whole problem contained in such questions arises simply from a supposition that is false and cannot in any way be proved, namely that, if the soul and the body are two substances whose nature is different, this prevents them from being able to act on each other (AT VII 213: CSM II 275).
So, Descartes’ response to the mind-body problem is twofold. First, Descartes contends that a response to this question presupposes an explanation of the union between the mind (or soul) and the body. Second, Descartes claims that the question itself stems from the false presupposition that two substances with completely different natures cannot act on each other. Further examination of these two points will occur in reverse order.
Descartes’ principles of causation put forward in the Third Meditation lie at the heart of this second presupposition. The relevant portion of this discussion is when Descartes argues that the less real cannot cause something that is more real, because the less real does not have enough reality to bring about something more real than itself. This principle applies on the general level of substances and modes. On this account, an infinite substance, that is, God, is the most real thing because only he requires nothing else in order to exist; created, finite substances are next most real, because they require only God’s creative and conservative activity in order to exist; and finally, modes are the least real, because they require a created substance and an infinite substance in order to exist. So, on this principle, a mode cannot cause the existence of a substance since modes are less real than finite substances. Similarly, a created, finite substance cannot cause the existence of an infinite substance. But a finite substance can cause the existence of another finite substance or a mode (since modes are less real than substances). Hence, Descartes’ point could be that the completely diverse natures of mind and body do not violate this causal principle, since both are finite substances causing modes to exist in some other finite substance. This indicates further that the “activity” of the mind on the body does not require contact and motion, thereby suggesting that mind and body do not bear a mechanistic causal relation to each other. More will be said about this below.
The first presupposition concerns an explanation of how the mind is united with the body. Descartes’ remarks about this issue are scattered across both his published works and his private correspondence. These texts indicate that Descartes did not maintain that voluntary bodily movements and sensation arise because of the causal interaction of mind and body by contact and motion. Rather, he maintains a version of the form-matter theory of soul-body union endorsed by some of his scholastic-Aristotelian predecessors and contemporaries. Although a close analysis of the texts in question cannot be conducted here, a brief summary of how this theory works for Descartes can be provided.
Before providing this summary, however, it is important to disclaim that this scholastic-Aristotelian interpretation is a minority position amongst Descartes scholars. The traditional view maintains that Descartes’ human being is composed of two substances that causally interact in a mechanistic fashion. This traditional view led some of Descartes’ successors, such as Malebranche and Leibniz (who also believed in the real distinction of mind and body), to devise metaphysical systems wherein mind and body do not causally interact despite appearances to the contrary. Other philosophers considered the mind-body problem to be insurmountable, thereby denying their real distinction: they claim that everything is either extended (as is common nowadays) or mental (as George Berkeley argued in the 18th century). Indeed, this traditional, mechanistic interpretation of Descartes is so deeply ingrained in the minds of philosophers today, that most do not even bother to argue for it. However, a notable exception is Marleen Rozemond, who argues for the incompatibility of Descartes’ metaphysics with any scholastic-Aristotelian version of mind or soul-body union. Those interested in closely examining her arguments should consult her book Descartes’s Dualism. A book arguing in favor of the scholastic-Aristotelian interpretation is entitled Descartes and the Metaphysics of Human Nature; Chapter 5 specifically addresses Rozemond’s concerns.
Two major stumbling blocks Rozemond raises for the scholastic-Aristotelian interpretation concern the mind’s status as a substantial form and the extent to which Descartes can maintain a form of the human body. However, recall that Descartes rejects substantial forms because of their final causal component. Descartes’ argument was based on the fact (as he understood it) that the scholastics were ascribing mental properties to entirely non-mental things like stones. Since the mind is an entirely mental thing, these arguments just do not apply to it. Hence, Descartes’ particular rejection of substantial forms does not necessarily imply that Descartes did not view the mind as a substantial form. Indeed, as Paul Hoffman noted:
Descartes really rejects the attempt to use the human soul as a model for explanations in the entirely physical world. This makes it possible that Descartes considered the human mind to be the only substantial form. At first glance this may seem ad hoc but it is also important to notice that rejecting the existence of substantial forms with the exception of the mind or rational soul was not uncommon amongst Descartes’ contemporaries.
Although the mind’s status as a substantial form may seem at risk because of its meager explicit textual support, Descartes suggests that the mind a “substantial form” twice in a draft of open letter to his enemy Voetius:
Yet, if the soul is recognized as merely a substantial form, while other such forms consist in the configuration and motion of parts, this very privileged status it has compared with other forms shows that its nature is quite different from theirs (AT III 503: CSMK 207-208).
Descartes then remarks “this is confirmed by the example of the soul, which is the true substantial form of man” (AT III 508: CSMK 208). Although other passages do not make this claim explicitly, they do imply (in some sense) that the mind is a substantial form. For instance, Descartes claims in a letter to Mesland dated 9 February 1645, that the soul is “substantially united” with the human body (AT IV 166: CSMK 243). This “substantial union” was a technical term amongst the scholastics denoting the union between a substantial form and matter to form a complete substance. Consequently, there is some reason for believing that the human mind is the only substantial form left standing in Descartes’ metaphysics.
Another major stumbling block recognized by Rozemond is the extent to which, if any, Descartes’ metaphysics can maintain a principle for organizing extension into a human body. This was a point of some controversy amongst the scholastics themselves. Philosophers maintaining a Thomistic position argued that the human soul is the human body’s principle of organization. While others, maintaining a basically Scotistic position, argued that some other form besides the human soul is the form of the body. This “form of corporeity” organizes matter for the sake of being a human body but does not result in a full-fledged human being. Rather it makes a body with the potential for union with the human soul. The soul then actualizes this potential resulting in a complete human being. If Descartes did hold a fundamentally scholastic theory of mind-body union, then is it more Thomistic or Scotistic? Since intellect and will are the only faculties of the mind, it does not have the faculty for organizing matter for being a human body. So, if Descartes’ theory is scholastic, it must be most in line with some version of the Scotistic theory. Rozemond argues that Descartes’ rejection of all other substantial forms (except the human mind or soul) precludes this kind of theory since he cannot appeal to the doctrine of substantial forms like the Scotists.
Although Descartes argues that bodies, in the general sense, are constituted by extension, he also maintains that species of bodies are determined by the configuration and motion of their parts. This doctrine of “configuration and motion of parts” serves the same purpose as the doctrine of substantial forms with regards to entirely physical things. But the main difference between the two is that Descartes’ doctrine does not employ final causes. Recall that substantial forms organize matter for the purpose of being a species of thing. The purpose of a human body endowed with only the form of corporeity is union with the soul. Hence, the organization of matter into a human body is an effect that is explained by the final cause or purpose of being disposed for union. But, on Descartes’ account, the explanatory order would be reversed: a human body’s disposition for union is an effect resulting from the configuration and motion of parts. So, even though Descartes does not have recourse to substantial forms, he still has recourse to the configuration of matter and to the dispositions to which it gives rise, including “all the dispositions required to preserve that union” (AT IV 166: CSMK 243). Hence, on this account, Descartes gets what he needs, namely, Descartes gets a body properly configured for potential union with the mind, but without recourse to the scholastic notion of substantial forms with their final causal component.
Another feature of this basically Scotistic position is that the soul and the body were considered incomplete substances themselves, while their union results in one, complete substance. Surely Descartes maintains that mind and body are two substances but in what sense, if any, can they be considered incomplete? Descartes answers this question in the Fourth Replies. He argues that a substance may be complete insofar as it is a substance but incomplete insofar as it is referred to some other substance together with which it forms yet some third substance. This can be applied to mind and body as follows: the mind insofar as it is a thinking thing is a complete substance, while the body insofar as it is an extended thing is a complete substance, but each taken individually is only an incomplete human being.
This account is repeated in the following excerpt from a letter to Regius dated December 1641:
For there you said that the body and the soul, in relation to the whole human being, are incomplete substances; and it follows from their being incomplete that what they constitute is a being through itself (that is, an ens per se; AT III 460: CSMK 200).
The technical sense of the term “being through itself” was intended to capture the fact that human beings do not require any other creature but only God’s concurrence to exist. Accordingly, a being through itself, or ens per se, is a substance. Also notice that the claim in the letter to Regius that two incomplete substances together constitute a being through itself is reminiscent of Descartes’ remarks in the Fourth Replies. This affinity between the two texts indicates that the union of mind and body results in one complete substance or being through itself. This just means that mind and body are the metaphysical parts (mind and body are incomplete substances in this respect) that constitute one, whole human being, which is a complete substance in its own right. Hence, a human being is not the result of two substances causally interacting by means of contact and motion, as Gassendi and Elizabeth supposed, but rather they bear a relation of act and potency that results in one, whole and complete substantial human being.
This sheds some light on why Descartes thought that an account of mind-body union would put Gassendi’s and Elizabeth’s concerns to rest: they misconceived the union of mind and body as a mechanical relation when in fact it is a relation of act and potency. This avoids Gassendi’s and Elizabeth’s version of this problem. This aversion is accomplished by the fact that modes of voluntary motion (and sensations, by extrapolation) should be ascribed to a whole human being and not to the mind or the body taken individually. This is made apparent in a 21 May 1643 letter to Elizabeth where Descartes distinguishes between various “primitive notions.” The most general are the notions of being, number, duration, and so on, which apply to all conceivable things. He then goes on to distinguish the notions of mind and body:
Then, as regards body in particular, we have only the notion of extension, which entails the notions of shape and motion; and as regards the soul on its own, we have only the notion of thought, which includes the perceptions of the intellect and the inclinations of the will (AT III 665: CSMK 218).
Here body and soul (or mind) are primitive notions and the notions of their respective modes are the notions “entailed by” or “included in” these primitives. Descartes then discusses the primitive notion of mind-body union:
Lastly, as regards the soul and the body together, we have only the notion of their union, on which depends our notion of the soul’s power to move the body, and the body’s power to act on the soul and cause its sensations and passions (AT III 665: CSMK 218).
In light of the immediately preceding lines, this indicates that voluntary bodily movements and sensations are not modes of the body alone, or the mind alone, but rather are modes of “the soul and the body together.” This is at least partially confirmed in the following lines from Principles, part I, article 48:
But we also experience within ourselves certain other things, which must not be referred either to the mind alone or to the body alone. These arises, as will be made clear in the appropriate place, from the close and intimate union of our mind with the body. This list includes, first, appetites like hunger and thirds; secondly, the emotions or passions . . . (AT VIIIA 23: CSM I 209).
These texts indicate that the mind or soul is united with the body so as to give rise to another whole complete substance composed of these two metaphysical parts. And, moreover, this composite substance now has the capacity for having modes of its own, namely, modes of voluntary bodily movement and sensation, which neither the mind nor the body can have individually. So, voluntary bodily movements are not modes of the body alone caused by the mind, nor are sensations modes of the mind alone caused by the body. Rather, both are modes of a whole and complete human being. On this account, it makes no sense to ask how the non-extended mind can come into contact with the body to cause these modes. To ask this would be to get off on the wrong foot entirely, since contact between these two completely diverse substances is not required for these modes to exist. Rather all that is necessary is for the mind to actualize the potential in a properly disposed human body to form one, whole, human being to whom is attributed modes of voluntary movement and sensation.
Although the scholastic-Aristotelian interpretation avoids the traditional causal interaction problem based on the requirements of contact and motion, it does run up against another version of that problem, namely, a problem of formal causation. This is a problem facing any scholastic-Aristotelian theory of mind or soul-body union where the soul is understood to be an immaterial substantial form. Recall that the immaterial mind or soul assubstantial form is suppose to act on a properly disposed human body in order to result in a full-fledged human being. The problem of formal causal interaction is: how can an immaterial soul assubstantial form act on the potential in a material thing? Can any sense be made of the claim that a non-extended or immaterial things acts on anything? Descartes noticed in a letter to Regius (AT III 493: CSMK 206) that the scholastics did not try to answer this question and so he and Regius need not either. The likely explanation of their silence is that the act-potency relation was considered absolutely fundamental to scholastic-Aristotelian philosophy and, therefore, it required no further explanation. So, in the end, even if Descartes’ theory is as described here, it does not evade all the causal problems associated with uniting immaterial souls or mind to their respective bodies. , However, if this proposed account is true, it helps to cast Descartes’ philosophy in a new light and to redirect the attention of scholars to the formal causal problems involved.
6. References and Further Reading
- Descartes, Rene, Ouevres de Descartes, 11 vols., eds. Charles Adam and Paul Tannery, Paris: Vrin, 1974-1989.
- This is still the standard edition of all of Descartes’ works and correspondence in their original languages. Cited in the text as AT, volume, page.
- Descartes, Rene, The Philosophical Writings of Descartes, 3 vols., trans. John Cottingham, Robert Stoothoff, Dugald Murdoch and Anthony Kenny, Cambridge: Cambridge University Press, 1984-1991
- This is the standard English translation of Descartes philosophical works and correspondence. Cited in the text as CSM or CSMK, volume, page.
- Broughton, Janet and Mattern, Ruth, “Reinterpreting Descartes on the Notion of the Union of Mind and Body,” Journal of the History of Philosophy 16 (1978), 23-32.
- A reinterpretation of the notion of mind-body union in the correspondence with Elizabeth, which addresses Radner’s interpretation of it. See below.
- Garber, Daniel, “Understanding Interaction: What Descartes Should Have Told Elizabeth,” Southern Journal of Philosophy, Supp. 21 (1983), 15-32.
- Article addressing the issues of the primitive notions and how this theory should be used to explain mind-body causal interaction to Elizabeth.
- Hoffman, Paul, “The Unity of Descartes’ Man,” The Philosophical Review 95 (1986), 339-369.
- Article arguing that Descartes’ theory of mind-body union is more in line with scholastic-Aristotelian theories of soul-body union than previously supposed.
- Kenny, Anthony, Descartes: A Study of His Philosophy, New York: Random House, 1968. See especially chapters 4 and 10.
- These chapters provide classic interpretations of the real distinction between mind and body and the mind-body problem.
- Mattern, Ruth, “Descartes’ Correspondence with Elizabeth Concerning both the Union and Distinction of Mind and Body” in Descartes: Critical and Interpretive Essays, ed. Michael Hooker, Baltimore: John Hopkins University Press, 1978, 212-222.
- Short essay examining Descartes’ correspondence with Elizabeth on this issue and how it was supposed to direct her to a correct understanding of mind-body causal interaction.
- Radner, Daisie, “Descartes’ Notion of the Union of Mind and Body,” Journal of the History of Philosophy 9 (1971), 159-170.
- This is the first article in Anglo-American scholarship to address the issue of mind-body union. It addresses several texts, including the letter to Elizabeth enumerating the primitive notions.
- Rozemond, Marleen, Descartes’s Dualism, Cambridge: Harvard University Press, 1998.
- This book argues for a particular understanding of the real distinction between mind and body that would preclude Hoffman’s scholastic-Aristotelian account of their union.
- Skirry, Justin, Descartes and the Metaphysics of Human Nature, London and New York: Thoemmes-Continuum Press, 2005.
- This book takes issue with Rozemond’s account of the mind-body union through a close re-examination of fundamental features of Descartes’ metaphysics and by building on certain features of Hoffman’s account.
- Voss, Stephen, “Descartes: The End of Anthropology” in Reason, Will and Sensation, ed. John Cottingham, Oxford: Clarendon Press, 1994.
- This essay provides a close textual analysis of Descartes’ account of the union of mind and body on the supposition that he maintained a Platonic rather than scholastic-Aristotelian theory of mind-body union.
- Williams, Bernard, Descartes: The Project of Pure Enquiry, Sussex: Harvester Press, 1978. See especially chapter 4.
- This is another classic account of the mind-body relation in Descartes.
- Wilson, Margaret, Descartes, London and Boston: Routledge and Kegan Paul, 1978.
- Provides classic accounts of the real distinction argument and issues concerning mind-body causal interaction.
U. S. A.
Why do so many teenage girls want to change gender? Posted April 5th 2021
In the last 10 years, there has been an extraordinary increase in teenagers seeking to transition from female to male. What’s behind it—and has the NHS been too quick to find a solution?
By Emma Hartley
It is commonly acknowledged that while biological sex is genetically determined, gender is a social construct. A human being cannot—and should not—be reduced to their biology, or indeed their genitals, because psychologically we are as much a product of the way that other people treat us as we are of our genetic inheritance. Homo sapiens are social creatures: our ability to cooperate is what gave us the evolutionary upper hand over our stronger Neanderthal cousins. Without parents, siblings, peers, colleagues, friends and lovers our idea of ourselves would remain ill-defined—we wouldn’t know who we were.
Imagine you were raised by wolves in a cave—let’s call you Mowgli—but then later met another human of the opposite sex. You would notice the physiological differences. But as to interpreting those differences, where would you start? Without being exposed to the concept of “man” or “woman”—let alone “laddish” or “girly”—you’d lack any mental map to provide the pointers to the typically “male” and “female” behaviour instilled in us by human society.
Precisely because gender is a social construct, the evolution of its boundaries and meanings will tell us something fundamental about our society. And gender-wise something really big is going on in the UK—but it’s not the big something you might think.
Transsexuality is a talking point like never before, and a glance at the figures sheds some light on why. The number of children, in particular, being referred to the Tavistock and Portman Foundation Trust’s gender identity development service (Gids)—the NHS service through which all UK candidates for a sex change under 18 are funnelled—is up from 77 in 2009 to 2,590 in 2018-9. But what’s almost as dramatic as the headline numbers are developments in who is transitioning. In November 2017, the Guardian reported that 70 per cent of referrals were female. This was a surprising statistic because only 10 years previously the overall ratio had been more like 75 per cent males seeking to be female, and indeed it is still the gender traffic in that direction that dominates the increasingly noisy, divisive and panic-inflected debate.
Recently, though, alarm bells have begun to ring among a handful of psychiatric professionals about the number of teenage girls arriving at the Tavistock’s door and the nature of their treatment. Right now a legal case is being brought by Susan Evans, a former psychiatric nurse at the Tavistock and Portman NHS Foundation Trust, alongside a parent of an autistic female child wishing to transition to be male, arguing that children are not legally capable of consenting to a gender transition. November last year saw the launch of the Detransition Advocacy Network, a UK group numbering several hundred members. And in January, the NHS announced an independent review into puberty suppressants and cross-sex hormone treatments, to be chaired by Hilary Cass, formerly president of the Royal College of Paediatrics and Child Health.
But until the end of 2019, you could be forgiven for thinking that a panic about trans women using the “wrong” toilet cubicles was the biggest gender issue of the day (instead of something that could be easily solved by affording everyone the same privacy). Whenever the issue flares up politically—as when the Labour leadership candidates were asked to sign a pledge that labelled trans rights sceptics as “hate groups,” or the Scottish government proposed reforms to allow a change of legal gender without a medical diagnosis of gender dysphoria—it always seems to come back to loos and changing rooms. These vitriolic debates keep bubbling up—especially online.
But there is a much bigger scandal brewing than any Twitterstorm. While there have been a great many thoughtful doctors at the Tavistock, the picture is sometimes disturbing. Marcus Evans, a psychotherapist and former governor of the Tavistock and Portman NHS Foundation Trust, resigned in February 2019, citing an institutional rush to prescribe puberty-blocking hormone treatment to children questioning their gender and who may wish to transition. “The Tavistock is behaving recklessly with these kids who are in a distressed state,” he claims. What’s especially odd about the alleged rush to prescribe rather than consider alternatives, he argues, is that this clinic’s international reputation was built on the quality of its talking therapy.
“Over the last five to 10 years there has been a complete change in the profile of the people presenting,” says Evans. “These children believe that they are in the wrong body and they are very persistent and forceful in saying that they want a solution—and that that is physical intervention. But I’ve been in psychiatry for 40 years and when people are in a distressed state they often narrow things down and fix on one thing as a solution, putting pressure on clinicians for a magic bullet.”
In psychiatry “generally,” he says, the aim is to “open things out,” and take the time to ask questions about “what is going on.” After all, “adolescence is a moving picture. We move through experimenting with different identities as our bodies change and our role in society changes. An individual has to tolerate a -certain amount of confusion and anxiety and we should be able to help with that through therapy.” But when it comes to “the Tavistock’s gender identity service,” he says, “this work has not been done… the entire area has become unnecessarily politicised.”
It is undeniable that trans people have faced discrimination and abuse from those who don’t understand their experiences. A vocal rights lobby is quick to push back against transphobia—both real and perceived. Sometimes, though, legitimate challenges tip over into intimidation.
An American academic, Lisa Littman, encountered strenuous opposition when she published an article that coined the term “rapid onset gender dysphoria.” She lost a consultancy job, though remained an assistant professor at Brown University School of Public Health. Littman identified knots of socially-awkward girls drawn together in online chat rooms who reinforced each other’s self-diagnosis of being transgender before presenting to medical professionals. She had been led there by research involving the parents of some of these children, who had mentioned that their offspring had friends who also identified as transgender. (The US is experiencing a similar shift towards female transitioners, as are Finland, Canada and the Netherlands among others.) Along with Marcus Evans, Littman has pointed to a high incidence of autism and eating disorders among the same patients who present as trans. That observation raises some obvious questions about the narrowness of an approach that fixates on hormonal treatment for gender dysphoria.
The Tavistock pushes back against accusations that it is too quick to assume its patients are transgender and to provide hormones. “Our work with young people is not to affirm or deny,” they told me. “We respect children and young people’s sense of themselves and our assessment process considers gender identity development within the context of a psychological, biological, developmental and social framework, meaning that it is designed to give assessors a broad picture of the young person’s past and current gender identification.” Their work, they went on, is “cautious” and “considered” and whatever clinical interventions they do undertake are “laid out in nationally-set service specifications.” Hormone blockers are prescribed. But surgery cannot be performed until the age of 18.
Anna Hutchinson, who worked at the Tavistock until 2017 as a clinical psychologist and who is now in private practice, isn’t convinced. She believes there is an uncritical “affirmation” of gender dysphoria and the Tavistock is not as “cautious” as it should be. “The young people are making sense of themselves in the best way they can,” she tells me. “They often aren’t aware of anything other than the affirmative approach for managing gender dysphoria.” If they heard “different points of view,” they might be better placed to make “balanced and informed decisions about what they need,” she suggests. She describes a rush to treat: “Affirmation involves a quick assessment and then you get them into the medical system, on to hormone blockers if this is age appropriate. The next step is cross-sex hormones with their irreversible effects. Nearly 100 per cent make that journey once they start on the blockers.”
Hutchinson suggested that I look at an advisory organisation called the World Professional Association for Transgender Health (WPATH), alleging that its “best-practice” guidelines in this field, which have been adhered to internationally and spread through professional development courses for practitioners, have often been activist-led rather than evidence-led. Critics charge that senior members of WPATH have been behaving as advocates for transsexuality, rather than dispassionate advisers on mental health. Indeed, such advocacy is included in WPATH’s mission statement.
The WPATH guidelines say that “children as young as two may show features that could indicate gender dysphoria. They may… prefer clothes, toys and games that are commonly associated with the other sex and may prefer playing with other-sex peers.” A very distinct perspective is on show here: one that venerates individual feelings of identity, and yet also regards the social categories of gender with such solemnity that a girl toddler’s fondness for toy tractors is now seen as a marker of dysphoria. There is little room for interrogating either the feelings or the categories: it’s the biology that needs to change.
The guidelines add: “Treatment aimed at trying to change a person’s gender identity and expression to become more congruent with sex assigned at birth has been attempted in the past without success… Such treatment is no longer considered ethical.” While the WPATH guidelines counsel against pathologising gender dysphoria, these guidelines arguably have the effect of pathologising the natal sex of the person in question.
WPATH has the level of influence that it does, it has been suggested to me, because until the sudden increase in numbers of people questioning their gender no one paid much attention. WPATH began as the Harry Benjamin International Gender Dysphoria Association in 1979, when there might only have been a few hundred patients a year presenting in the UK and these tended to be adult males. Each could be dealt with on a case-by-case basis. Given the vast and rapid increase in the number of people wanting to change gender, there is bound to be a danger that discretion goes out of the window, and “guidelines” become rigid rules. (WPATH did not respond to questions.)
“The WPATH guidelines may have had the effect of de-skilling professionals who have been trained to provide therapy,” says Hutchinson, adding that in Gids the clinic simply “can’t” provide the traditional therapy for which the Tavistock is known, and which medics from across the country might expect when they refer patients here.
Hutchinson points to Gids’s own service specification (which doesn’t include talking therapy as a long-term treatment option) and a memorandum about conversion therapy published by the UK Council for Psychotherapy in 2017. Along with the influence of WPATH it is, I think, the missing piece of the jigsaw that reveals how the “affirmation” approach to gender reassignment has become the norm in the UK.
“Different issues may have been conflated, despite the best of intentions,” explains Hutchinson. She argues that a “false equivalence” has been drawn between pro-active conversion therapy for sexuality, where clinicians attempt to alter patients’ sexual responses, and talking people into becoming more comfortable with their bodies. Non-medical therapy for people with gender dysphoria has come to be seen as effectively trying to argue them out of identifying as transgender, as people were once convinced that they shouldn’t be gay. But the distinction between medical acts and medical omissions has been lost somewhere here, a serious matter in a profession whose traditional starting point has been “First, do no harm.” (The Tavistock responds: “We operate with no preconceptions and outcomes for any given young person.”)
Traditional ideas about the physician assessing the patient in the round also seem at risk of being forgotten. “We generally don’t talk about the relevance of the incredibly high incidence of autism spectrum disorder among these new, young, female patients,” says Hutchinson. “Autism often also means black-and-white thinking and struggling with the onset of puberty, so we have to ask the question ‘can this simply be a coincidence?’” And can it be a coincidence, either, that the stampede to transition is so concentrated among girls and young women?
An instructive parallel case can be found in Eastern Europe. In the former Soviet bloc, and especially in 1980s Poland, more women than men requested sex changes. “Polish sexologists knew about this difference [with the west] and were startled by it,” said Ludmila Janion of Warsaw University, who recently completed a PhD on the subject.
Why was this? The experts I spoke to while researching a book in the 2000s suggested that the reverse statistics might have something to do with it being especially awful to be a female under Communism, propelling some to jump immediately from questioning their sexuality—“I’m not sure I’m straight”—to the conclusion: “I must be a man.”
Current figures are hard to come by in capitalist Poland, but a 3:1 ratio of women becoming men as against men becoming women has been suggested to me. So perhaps it was actually less about Communism, than more ingrained cultural issues. Anna Kłonkowska, a Polish academic living in New York, suggests interrogating the very words that Eastern Europeans use: “Slavic languages are highly gendered,” she explained. “There is no distinction possible within them between sex and gender: no separate words for these things. It is linguistically assumed that your anatomical features are the same as your perceived gender. It is not only the case with verbs (as in French) but also nouns and adjectives, and when you speak you express your gender in every sentence as well as the gender of the person to whom you are speaking.” Additionally, said Kłonkowska, “Cultural elevation of masculinity is built into the language: -transitioning female to male is seen as socially elevating whereas transitioning male to female is degrading.”
All of this makes conversation uncomfortable to anyone who is not quite sure where they fit in. Female to male trans people have told Kłonkowska that “their biggest concern” is “not really about the bodily alterations” but “merely being treated as male.” Unfortunately, in Poland, there is no way to have the one without the other. “Judges generally want to see some physical changes before they will allow the legal one. People say that they feel forced to take hormones so that a judge will see a man or a woman even though they are not unhappy with their existing bodies. Then afterwards they would give up taking the hormones.”
Whether the root cause is language, the legacy of Communism or patriarchal oppression, this is a story that needs to be understood at the level of society, not just the individual psyche. There is little doubt—as Janion argues—that there was traditionally “no cultural space for butch (ie more masculine) lesbians.” Transsexuality was perceived by the sexologists as a rare and difficult—but curable—illness. In this case it might have constituted a relatively attractive identity. After all, it turned a lesbian living with another woman into a success. Sexologists saw it as restoring “normal” heterosexuality. A similar trend can be seen in Iran, where gender reassignment surgery is encouraged for gay men who would otherwise be viciously persecuted.
“Whether someone will identify as trans or will be diagnosed as trans,” Janion argues, “will depend on what the other viable options are.” At which point it seems worth asking what, given the similar trend emerging in the UK and other western societies, might have changed to make so many youngsters born female feel so alienated in their own bodies?
A video of the launch of the recently constituted Detransition Advocacy Network sheds especially interesting light here on some young women’s struggles. The panel comprised of five women between 20 and 23 years old, plus the organiser, Charlie Evans, 28. All six are lesbians whose youthful feelings of self-loathing, self-disgust and social dislocation led them to make a decision to transition to male that they later came to regret, after varying degrees of hormone and surgical treatment.
Evans, in common with her panel-mates, now locates the source of her gender dysphoria as social (rather than personal)—and in particular in misogyny towards “masculine” women and lesbians. All six participants are now on better terms with their own lesbianism. “Gender dysphoria is the opposite of body positivity,” one of them says. But it was a harrowing and physically disruptive journey to have taken at such a young age. (All began their transition during puberty some time ago, and therefore have not been a part of the current controversy surrounding puberty-blocker drugs.) One man in the audience, audibly distressed at what he was hearing, asks: “How is it possible that you have had no one in your lives to tell you that it was OK just to be yourselves?”
There are broader questions here for UK society in 2020, and about its attitude to girls. It is hard not to feel that social media and porn have recently been conspiring to create a rigid and ultra “femme” idea of what a beautiful woman should look like. Whereas once Jamie Lee Curtis, with her short hair and athletic build, was considered a sex symbol in Hollywood, these days the Kardashians’ femininity can feel almost as homogenised as it is commoditised. And its shallow markers—nails, lashes, bling—frequently blur the distinction between the world’s most desirable women and drag queens. Keeping up with the requirements of womanhood, as they are understood in these times, imposes a time-sapping burden, and all those (most of us) who are not prepared to devote a large portion of our day to our appearance end up feeling alienated. Detransitioners might well be merely exposing the tip of an iceberg of social-media generated misery.
Phoebe Jones (not her real name) is a lesbian attracted to masculine women who mourns the shrinking of her dating pool. “I’ve always tended towards dating masculine-of-centre women,” she tells me, “I’ve never seen these women as having less of a claim on womanhood than I do… Their self-acceptance was important to me as it allowed me to celebrate them.”
The trappings of femininity can be oppressive.
But it’s not always easy. One lesbian friend was raped by a classmate when she came out. Another “was cripplingly insecure in clothes but confident naked. I gently pointed out to her that her body wasn’t the problem. She breast-bound and tentatively used gender neutral pronouns. We became good friends. Now she sees herself as a woman and a lesbian and still looks like a boy. I get the feeling she is comfortable being desired as such these days, and desiring too.”
This success story speaks of a relatively “masculine” woman learning to find her psychological comfort publicly and privately—something far too rarely reflected in the media in the era of Love Island. Such happy negotiations of identity remain largely unacknowledged—to the detriment of others who are still stuck with the anguish that preceded the happy resolution.
“Increasingly on dating apps,” explains Jones, “masculine lesbians use they/them pronouns… If anything, it almost seems more common now than just being a proudly butch lesbian, particularly in younger women.”
Jones is at pains to point out that she does not have a problem with people transitioning, “if they are old enough and have had appropriate therapeutic support. But when it comes to adolescent girls wanting to transition, I find it very sad… I had terrible mental health as a teenager and if the same kind of agonising and reckless drive towards destruction and away from discomfort is shared by any of these girls, I can’t help but mourn the trend to assist them in taking this drive to the logical extreme rather than helping them learn to live with themselves. I mean, to help them learn to cope with their internal contradictions for at least long enough that a decision to transition is an adult, reflective and thoughtful decision.”
Many outside and indeed within the UK’s Gids service fear that, far from freeing people from the constraints of “being in the wrong body,” over the last 10 years the Tavistock has—with the best of intentions—been giving effect to some of society’s unkindest (if internalised) prejudices. What a tragedy it would be, if in trying to learn from the historic misstep of gay conversion therapy, we are allowing a rushed regime of transitioning young people that will one day be remembered in an equally controversial way. History does not repeat itself, but it does rhyme.
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The following post will only make sense if read in conjunction with posts on About R.J Cook. The missing dynamic here is the police, which the NHS bodies refuse to admit or explain. This is the draft of a letter circulated to a number of lawyers for the purpose of staying within Statute of Limitations as all relevant public bodies refuse to explain anything, other than to label me as paranoid, ultimately bound for death by misadventure, hospitalisation, suicide or jail.
Ramsay, the psychiatrist ( sic ) noted in his report that if I saw all of the official records held on me, then I would be ‘upset.’ Fancy telling that to a person you have diagnosed as paranoid !The following was addressed to a specific lawyer. Obviously when they inquired they were told that I am subject to an ongoing police investigation and dangerous. R.J Cook December 4th 2020
“‘Thanks for getting back to me and I apologise for the delay in replying. I have given an outline of my situation below, as briefly as possible. More details and documents are available, if you feel you can help and proceed. My health is getting worse as a result of all that has happened to me. I thank you for your kind attention.
Summary of case involving Roberta Jane Cook
In 2016, I made an appointment at my local surgery with Dr Baines Clark, of Norden House Surgery, reference the possibility of me being transgendered. That surgery is Norden House Avenue Road Winslow, Bucks MK18. She referred me to Dr C.R Ramsay, a consultant pyschiatrist at Aylesbury’s Whiteleaf Centre. specialising in geriatric mental health care. He confrmed that I was in good physical and mental health – I have his report from 2016 confirming that I am suffering from no known mental illness . Ramsay concluded that I was a suitable candidate for the GIC and their services.
I then attended the GIC Clinic, had various assessments and consultations, but when it came to medication there were.several communications made known to me where Dr Roger Dickson of Norden House raised questions about my mental health and told them that my alleged heavy drinking meant my liver would struggle with hormone treatment. I was copied in to Dickson’s correspondence by Leighton Seal of the GIC who thanked Dickson for ‘five interesting letters.’
Dickson’s surgery had also ignored my prostate concerns since 2003 and my seriously raised free testosterone and abnormal Sex Hormone Binding Globulin ( SHBG ) levels on the basis that this was probabaly linked to alcohol abuse. By the way, I am not a heavy drinker and spent years working as an HGV driver until lockdown.).’This correspondence, from Dickson to Leighton Sea,l came one year after I had changed my name and conformed to their dress and behaviour requirements. I was offered no explanation or evidence.
As a matter of fact, taking anti androgens and alcohol is a serious health risk, so if I was a ‘drinker’ they were negligent at the GIC or suspected Dickson of lying. I am hypothyroid so regular liver and kidney function blood checks were routine for me. Dickson and his colleagues had regfularly signed me off on medicals as fit to drive HGVs, noting that I was not an alcoholic or mentally ill.
Dr Leighton Seal of the GIC overruled Norden House. Hormones, anti androgens and injections effectively chemically castrating me were prescribed. By February 2018, I was overdue to be listed for GRS ( Gender Reassignment Surgery ).
So, at my February 2018 meeting with Dr Kirpal Sahota of the GIC , Dr Sahota announced, apparently out of the blue, that my GRS was conditional on me taking anti psychotic drugs. She also said that I needed sessions with a psychiatrist from the Whiteleaf Centre. She had a male colleague present with a view to my long term therapy under this dangerous medication. Had the GIC et al done their job properly, and this not being connected with Norden House misconduct, then this medication with reasons would have been mentioned to me at the beginning – not after high risk hormone and anti androgen treatment. As it was, hormones, anti androgens, injections, facial hair removal and conforming to their dress code, my identity had been overwhelmed and myself put at risk from hate crime and social ostracism. In this context, I was suddenly expected to take anti psychotics, function and survive.
The situation is now compounded by Covid 19 lockdown, my son and I facing homelessness because of what has been done to me. One does not have to be mad to commit suicide – they know that. My ex wife admitted her habit of hitting me, and there was much worse, leading me to attempt hanging from a door handle in March 2007. You need to know this as my medical records appear to be subject to edit and direction. My ex wife was a senior employee of Dr Roger Dickson & Co – my GP practice. I also spent several years working there as a handyman, attending their social functions. My work there included extending the staff car park using a large digger, plumbing and re roofing an outbuilding.
As a psychology post grad, I had knowledge of anti psychotics, how they work, purpose and side effects. I was simply told that they would make me better without being told why they suddenly thought I was seriously mentally ill. Offering a path to over due GRS, Dr Sahota’s words were. ‘We would like you to take the medication, it will make you feel better and then we can deal with the GRS. Is that a deal ?’ I said no, also refusing the group therapy sessions and Whiteleaf psychiatric consultations. By this time my body was physically altered, along with hormone effects on my mental state. My genitals have since wasted away to the point where GRS would be very difficult if at all possible to any good worth while effect. Still Norden House, Whiteleaf and the GIC refuse to explain anything relating to me and gender reassignement..
The same month in 2018, prior to Ramsay’s visits., Sahota wrote to my GP, copying me in to a letter she had sent to my GP, informing him that I had secure female identity and was keen to proceed fo GRS. The letter approved further castration injections with the purpose of reducing my testosterone level to the approved level for surgery. Curiously, a few days later, psychiatrist, Dr C.R Ramsay arrived unannouced, along with a medical student and mental health nurse. I had just returned from a 13 hour HGV – which Ramsay turned into alcoholism, along with calling my efforts to defend myself ‘pressured speech’ which was a sign of a paranoid personality disorder – his ultimate and damning diagnosis..
I was warned that hospital was a possibility, so would best invite them in if I wanted a chance to avoid that. Two further afternnon sessions followed, both times after I had been at work – my usual work start times were between 0100 and 0200 hours. This is relevant because it was my custom to sip a glass of wine after work and prior to bed before my next shift
I protested against Ramsay’s intrusions.
After my third consultation, and well over a month later Ramsay phoned to ask me if I would accept a second opinion because GIC ‘wanted something stronger’ than he had written about me. I was working at the time, but he persisted. I told him that it was up to him to make that decision. I later discovered that Ramsay had already informed the GIC that I had refused a second opinion before he even asked me. Ramsay concluded that I have abnormal psychology as well as paranoia and recommended a multi agency approach to monitoring me, but ‘hospital is not needed yet;’ He also concluded that I am anti social, secretive and cannot relate to others or sustain relationships. That was 2 years ago.
Neither Norden House. Whiteleaf or GIC have so far responded to the questions raised here. Obviously I have thought of suicide in this impossible situation. Paranoia is ‘abnormal suspicion’, schizophrenia is normally taken as multiple personality. I have had no empirically based explanation as to why they suggest all of this applies to me, and if it does then why were these agencies so careless and incompetent as to not notice before February 2018 and when GRS should have been imminent. If they had this view before then, why not act and why not eplain themselves to myself or my son ?
Several months ago Dr Kimble, of Norden House, wrote informing me that he had written to ask the GIC for an update on my status with them. I wrote thanking him, noting it would be interesting as to their reply, regarding what they did or didn’t say. Not surprsingly, I have not been told anything. .
So, in conclusion, if there is any truth in allegations and mental health diagnoses , then the key question is why on earth was I ever recommended for such serious gender re assignment treatment, lasting for 2 years, what were the reasons, the details of diagnosis etc ?. If they do not stick by their allegations and diagnosis, why not because it obviously implicates them in misconduct and misdiagnosis otherwise ? They were asking me at the GIC to take take very dangerous anti psychotics. as part of a bargain for sex change surgery ? That is serious, demanding serious explanation, the details should be provided on paper, also explaining all parties involved and why it took so long. They have refused to do that by ignoring all of my requests.
So the situation pertains and worsens. The effect on my physical and mental health has been extreme, my alarm and distress is ongoing – worsening in fact. The physical and psychologcal damage is dreadful and on going. leaving me in gender limbo, impotent and infertile. There is clear evidence of prejudice, malpractice, medical neglect, questionable diagnosis and practice – with external influence and malice that needs to be verified and explained to me in writing..I can answer any questions arising from what the various involved parties may offer in their defence. All concerned have had ample opportunity to explain themselves to me. I think their silence says a lot about them.
Yours Sincerely R.J Cook “